HCG注射前血清孕激素升高的持续时间对体外受精-胚胎移植的影响

摘要/Abstract

摘要： 目的: 探讨在控制性超促排卵（COH）过程中HCG注射前孕激素水平升高的持续时间对体外受精-胚胎移植（IVF-ET）妊娠结局的影响。方法: 选取2012年1月～2014年12月在安徽省立医院生殖医学中心行IVF-ET或 ICSI-ET助孕的398例不孕症患者的临床资料，根据HCG注射前（包括HCG注射日及前一日）血清孕激素水平持续2天在同一范围分为3组：A组P水平<1.5ng/ml 连续2天，B组P水平1.5ng/ml~2.0ng/ml 连续2天，C组P水平>2.0ng/ml 连续2天。对上述各组的临床资料进行回顾性分析，比较各组患者的促排卵效果及周期妊娠结局。结果:三组患者年龄、不孕年限、Gn天数、Gn用量、获卵数、正常受精率、可移植胚胎率及优质胚胎率的比较均无统计学差异（P> 0.05）。C组(P>2.0ng/ml连续2天)与A组比较，生化妊娠率、胚胎种植率、临床妊娠率以及活产率均明显下降 (P< 0.05)；B组(P=1.5ng/ml~2.0ng/ml 2天)与A组比较，生化妊娠率、胚胎种植率及临床妊娠率明显下降(P < 0.05)。结论: 控制性超促排卵中，HCG注射前连续2天P>2.0ng/ml 与体外受精-胚胎移植的妊娠结局呈负相关；HCG注射前连续2天P=1.5-2.0ng/ml生化妊娠率、胚胎种植率及临床妊娠率有明显下降，但对活产率及促排结局无明显影响。

关键词: 孕激素水平, 妊娠结局, 控制性超促排卵, HCG

Abstract: Objective: To explore the impact of the duration of elevated progesterone level before the time of HCG administration on pregnancy outcome of in vitro fertilization during controlled ovarian hyperstimulation (COH) . Methods: From January 2012 to December 2014,the data of 398 infertile patients receiving IVF-ET or ICSI -ET in the hospital were selected as study groups, according to the serum progesterone level lasts 2 days in the same range before the time of HCG administration(including the day of HCG injection and the previous day), the patients were divided into three groups ,group A:progesterone ＜1.5ng/ml for two days; group B progesterone 1.5~2.0ng/ml for two days; group C:progesterone>2.0ng/ml for two days. Analyzed retrospectively of?these data, then the cinical data and the outcomes of IVF/ICSI-ET were compared among the 3 groups.Results: There was no statistical difference in Age, duration of infertility, the mean total dose of gonadotropin, number of oocyte retrieval, and rate of normal fertilization, available embryo and high-quality embryo among the 3 groups（P>0.05）. Compared with the group A, P > 2.0ng/ml for two days group significantly reduced in biochemical pregnancy, implantation , clinical pregnancy and live-birth?rate（P<0.05）. The biochemical pregnancy ,implantation and clinical pregnancy rate of group B(P=1.5ng/ml~2.0ng/ml for two days) significantly lower than group A（P<0.05）. Conclusions: In controlled ovarian hyperstimulation , there was a negative impact on outcome of in vitro fertilization when the P>2.5ng/ml on the day of HCG administration and the P>2.0ng/ml for two days before the time of HCG injection; the P=1.5ng/ml~2.0ng/ml for two days before the time of HCG injection could decrease the biochemical pregnancy, implantation and clinical pregnancy rate.However, there were no obvious influence to the live-birth?rate.

Key words: Progesterone level, Pregnancy outcome, Controlled ovarian hyperstimulation, Human chorionic gonadotropin

乔宗惠李道静庞丽娥鲍蔓蔓刘雨生童先宏吴丽敏. HCG注射前血清孕激素升高的持续时间对体外受精-胚胎移植的影响[J]. 国际生殖健康/计划生育, 2017, 36(1): 9-13.

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